In these trying times of the COVID – 19 pandemic, doctors in Georgia are looking to cannabis for solace, and it seems like they have found some.
In a rather fortunate spin-off, scientists from the Dental College of Georgia (DCG) and the Medical College of Georgia have recently discovered that cannabidiol (CBD) can help reduce lung damage caused by COVID-19 by causing an increase in levels of a natural peptide – apelin.
The study is a spin-off from another study conducted by the same institution earlier this year. In that study, the researchers demonstrated that CBD has the ability to improve oxygen levels, reduce inflammation and reverse physical lung damage related to adult respiratory distress syndrome (ARDS). The mechanism behind the results is what the new study is based upon.
In the first research, the scientists were able to demonstrate that CBD normalizes levels of a peptide – apelin, which is known to reduce inflammation.
Since during a COVID – 19 infection, the levels of the peptide are low, the researchers believe that the peptide clearly has an important role to play and that CBD can cause an increase in the levels of apelin in patients suffering from lung damage due to COVID – 19.
The results have been published in the Journal of Cellular and Molecular Medicine.
Reducing inflammation with CBD
The authors emphasize that they do not yet know whether the novel coronavirus or CBD has a direct effect on apelin, or if these are downstream consequences, however, they are already working to find out. There is still much work to be done but, preliminary results show great promise for apelin as a good biomarker indicator for ARDS and by extension the novel coronavirus.
In the authors’ ARD model, it was indicated that blood levels of apelin, which is an important regulator in bringing both blood pressure and inflammation down, dropped close to zero and increased 20 times with CBD.
“Ideally with ARDS it would increase in areas of the lungs where it’s needed to improve blood and oxygen flow to compensate and to protect,” said Dr Babak Baban, DCG immunologist. But when the authors looked at their ARDS model, apelin did not do either, and instead decreased in both the lung tissue itself and the general circulation. However, this changed when they administered CBD.
The COVID-19 virus enters the human cells via the angiotensin-converting enzyme 2, otherwise known as the ACE2 receptor. There is plenty of common ground between ACE2 and apelin; the two normally work together to control blood pressure and are often coexisting in many cell types and tissues including the lungs.
Coronavirus appears to upset this positive partnership, with the virus having the ability to bind to the receptor for ACE2. This has been shown to decrease ACE2 levels and increase levels of the powerful blood vessel constrictor angiotensin II, which worsens the patient’s prognosis.
“Instead of ACE2 helping blood vessels relax, it helps the virus get into the host where it makes more viruses instead of helping the lungs relax and do their job,” says Yu.
CBD as a natural apelin agonist
The researchers are continuing their study to understanding the interaction between CBD, apelin, and the novel coronavirus, including why apelin goes down in the face of the virus and why CBD brings it up.
They are exploring how eliminating apelin affects ARDS and if CBD produces the same lung benefit without apelin.
The authors note that it is likely the virus suppresses something that suppresses apelin and CBD interferes with this process, however, they also doubt the apelin-CBD interaction is the only way the compound works in this and other scenarios.
The methodology of the study
To carry out the studies, the authors developed a safe, relatively inexpensive model of ARDS by giving a synthetic analog of double-stranded RNA called POLY (I: C). the novel coronavirus also has double-stranded RNA, while human DNA is single-stranded.
The model produced a response similar to the virus; including the extreme lung damage and the “cytokine storm” that reflects an over-the-top immune response in the lungs.
For these studies, a control group received intranasal saline for three consecutive days while the COVID-19 model received POLY (I: C) intranasally for three days. A third group, the treatment group, received POLY (I: C) and CBD over the same timeframe.
The researchers found significantly reduced apelin levels in the mice that developed COVID-like symptoms compared to controls, and treatment with CBD normalized the immune response and apelin levels, along with oxygen levels, swelling, and scarring in the lungs.
“The apelinergic system is a very, very ubiquitous signalling system,” Yu says. The authors note that apelin has diverse jobs in different places and that its levels are consistently measurable in the lungs, one of the reasons it should be a good biomarker.
They add that CBD appears to be a natural apelin agonist.
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